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Titolo:
Operation for anorexigen-associated valvular heart disease
Autore:
Caccitolo, JA; Connolly, HM; Rubenson, DS; Orszulak, TA; Schaff, HV;
Indirizzi:
Mayo Clin & Mayo Fdn, Div Cardiovasc Surg, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Surg, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Cardiovasc Dis, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Dis, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Internal Med, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Med, Rochester, MN 55905 USA Scripps Clin, Div Cardiovasc Dis, La Jolla, CA USA Scripps Clin La Jolla CA USA Clin, Div Cardiovasc Dis, La Jolla, CA USA
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 4, volume: 122, anno: 2001,
pagine: 656 - 664
SICI:
0022-5223(200110)122:4<656:OFAVHD>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY PULMONARY-HYPERTENSION; APPETITE-SUPPRESSANT DRUGS; PLASMA FENFLURAMINE LEVELS; WEIGHT-LOSS; OBESE PATIENTS; CLINICAL-TRIAL; DEXFENFLURAMINE; PHENTERMINE; VASOCONSTRICTION; REGURGITATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Schaff, HV Mayo Clin & Mayo Fdn, Div Cardiovasc Surg, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 5 USA
Citazione:
J.A. Caccitolo et al., "Operation for anorexigen-associated valvular heart disease", J THOR SURG, 122(4), 2001, pp. 656-664

Abstract

Objectives: Recently, valvular regurgitation has been observed in patientswho have taken fenfluramine or dexfenfluramine with or without phentermine. This study describes the clinical, echocardiographic, and pathologic findings of anorexigen-associated valvular heart disease and the surgical interventions required to treat it. Methods: We reviewed clinical information on 14 patients with severe anorexigen-associated valvular disease who underwent cardiac operations. Results: Thirteen women (mean age 44.2 +/- 5.3 years) received fenfluramine, 58.5 +/- 22.3 mg/day, and phentermine, 32.1 +/- 11.4 mg/day, for an average of 12.1 +/- 7.3 months before presentation. One woman received dexfenfluramine, 30 mg/day for 13 months, and phentermine, 60 mg/day, concomitantlyfor 6 months. Presenting symptoms included dyspnea (12 cases), palpitations (3), and atypical chest pain (3). Six patients had heart failure, and 4 had a new murmur. Echocardiography demonstrated severe mitral valve regurgitation in all patients. Seven also had aortic regurgitation, and 4 had significant tricuspid regurgitation. Four patients had successful mitral valve repair, I with concomitant aortic valve repair. Ten additional patients eventually required mitral valve replacement, 5 with concomitant aortic valve replacement. Excised valves demonstrated a glistening white appearance with plaque-like encasement of leaflets and chordae. Focal surface proliferationand fibrosis with a "stuck-on" appearance was consistently found. Conclusions: Anorexigen use may lead to severe multivalvular regurgitationwith characteristic echocardiographic and pathologic findings. Recognitionof drug-induced valvulopathy is important because of widespread use of these medications and the uncertain natural history of the disease. Early surgical experience suggests that valve repair is possible in these young patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 08:50:56